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Home My WebLink About3107-zF~OEM 1~O. 4 TOWN OF SOUTHOLD BUILDING DEPAETMENT TOWN CLERK'S OFFICE $OUTHOLD. N. Y. I-:EI~TI~II~AT£ rIF rICrI. UI~ANI~¥ No. :~ .2509 .... Date ................. At~g~a~;.. 19.., 19.66 THIS CERTIFIES that the building located at~/:~mmO~ .&. '~ehO]~ .Iaa~O Street ............. No ............. Lot No. 27.~ .... l]0U?,ahold~. ~I,Y.~ ......... conforms substantially to the Applicati. on foi' Building Permit heretof, ore filed in this office dated ............. ~I~y...31 .... 19(~. pursuant to which Building Permit No.. ~10~..~ dated ............ l~&~...~3. .... 19.66, ~vas issued, and conforms to all of the require- ments ,of the .applicable provisions of the law. The .occupancy f. or which this certificate is issued is . I~l,~.V~e..one. fsmii'17 · clwe~'lir/g ......................................... : The certificate is issued t.o .~ohla. I-ill~ ............ 0Wlqel5 ........................... (owner, lessee or tenant) of the aforesaid building. .Suffolk County Department of Health Approval . J1aIle...i}+F .1966. · .]~r..It,. ~l.l-l.& .... Building Inspector FOI~M NO. 2 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFF~C£ SOUTHOLD, N. Y. BUILDING P[RMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 3]07 Z Permission is hereby granted to: And~. ~.w.. ~/l,~x... A/,C... · 2'oh~r~,..~&a ................... ........... .~....2,;,g..../k ................................................ at premises located at ~0~ ~7.....N~>o~]~ghts...~mte,~ ................................. :... ................ ....................... N :l.xad. ;jato?. ~xt....La.. ~. 12mnhmv.....~. a.u~ .............. ~ ~ho:Ld: ....... ; .............................. pursuant to appiication '~Jated ............................ }'¢t~gt..Lj....3~.i: ........ I~.,., and approved by the- Building Inspector Fee $..~,O.t..O,..O. ......... Building Inspector S-9 SCHD SUFFOLK CoUNTT DEPA~d~ENT OF HEALTH Nldg. Permit No. ~/ OZ ~- TO WHOM 1T MAY CONCERN: The sewage disposal facilities for a structure located at have been inepeeted by %i~s Depa~ment and found to be satis£act, oryo District Enginee~ '" DiStrict Engineer FOI~M NO, 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICB SOUTHOLD, N. Y. Examined ................... /,. .................. , ........ Approved ........................................ , 19 ...... Permit No ............................. Application No. :(..0......~. ............. APPLICATION FOR BUILDING PERMIT Date "~'- '~ / 19 G 6 INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted in duplicate to the Building Inspector. b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public streets or areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this application. c. The work covered by this application may not be commenced before issuance of Building Permit. d. Upon approval of this application, the Building Inspector will issue a Building Permit to the applicant. Such permit shall be kept on the premises available for inspection throughout the progress of the work. e. No building shall be occupied or used in whole or in part for any purpose whatever until a Certificate of Occupancy shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, ,as herein described. The applicant agrees to comply with all applicable laws, ordinances, building ~ode and regula,tfqns. (Sign.c4ture of applicant, or name. if .a (Address of applicant) State whether applicant is owner, lessee, agent, architect, eqgineer, general contractor, electrician, plumber or builder. Name of owner of premises ..... ~..O....~.....~. ......... L....~,N:....,..~... ....................... : .......... .. ' ............. If applican~ i~S ~'~gr~dr;~t'e, ~jgnature' al(dally' a~ithorized o_Lf[cer. ..................... (Name and title of corporate officer) l. Location of lend on which proposed work will be done. Map No.: ...~.~t~.~.~9,..~....~.J.¢~..H..~ I_o~ No!: .~...~'.. ............. Street and ......... :/ .................................................................................................................................................. Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and accupancy ................................................................................................................................... b. Intended use and occupancy .......... ..~..~/Z.~..,.L...L.~..~...., .~,. .......................................................................... : ............... 10. 11. 12. 13. I Not~re of work (check which applicable): New Building .................. Addition .................. Alteration Repair .................. Removal .................. Demolition .................. Other Work (Describe) Est , oted Cost ................... Fee (to be paid on filing this application) If d~velling, number of dwelling units ........... ./. .......... .....Number of dwelling units on each floor If g~rage, number of cars ............... If ~usiness, commercial or mixed occupancy, specify nature and extent of each type of use Dimensions of existing structures, if any: Front ........... ~q ................ Rear ................................ Depth Hei!lht ..................... Number of Stories Dimensions of same structure with alterations or additions: Front ............ ~-. ....................... Rear Dap :h ................................ Height .............. ..~. .......... Number of Stories ................................ Dirrensions of entire new construction: Front ............................ Rear ...... ..0....~. .............. Depth cC Hal!Iht .................... Number of Stories .............. ./.././~......~...~..'f.~.~.~.. .... ~_~(~ Size of lot: Front ........ l..t~..v ........... Rear ....... ,:~m~ ................ Depth ....... /...~. .................... Dat~ of Purchase ....... .~../..~..~.. ................. ' ............... Name of Former Owner ~/~..~....~ Zon or use district in ¢vhJch premises are situated Doe proposed construction violate any zoning law, ordinance or regulation? ............ ~) o Nar ~e of Owner of premises ...~.H:...~.......~,..~.....~. .......... Address ;~.~.~...w.~?~.~..~.~..~..u.~.....~..~. '/~ ~'~oPhone ...... ~ U ,~.. ......... ?/~ Nar ~e of Architect .....~J.o..~..~.~.......k,.L.,N..~. ................... Address ............................................ Phone No. Nar ~e of Contractor /Ir.~J~q¥.Y.....~.J...u&,~.~..'TC~... ............ Address .....~..~¢.?~.......~..~..~...c..~.~ ...... Phone PLOT DIAGRAM I.ocat~ clearly ond distinctly ail buildings, whether existing or proposed, and indicate all sera,ack dimensions property li;nes. Give street and block number or description according to deed, and show street names and. whether in1 erior or corner lot. STATE O~ NEW YORK. ~ S S J J g ~ ~ ~ N ~ J(Name of individual signing application) obo,e n ed. He i, th, .............. j (Contractor, agent, corporate officer, etc.)' of said o~ner or owners, and is duly authorized to perform or have performed the said work and to make ~nd this application; that all statements contained in this application are true to the best of his knowledge and belief; that the work will be performed n the manner set f~h in the application filed therewith. Sworn to ~efore me this Pu~[ic~~~~~ ...... County (Signature of applicant) Notary